1. careers
2. nursing

ISSUE
coming together as one
SHOWCASE
Enhancing Care
through Quality
and Productivity
PAGE 6
SPOTLIGHT
A Day In the Life of...
PAGE 4
22
TEST YOUR WITS!
Take part in
our quiz and
stand to win
attractive prizes!
PAGE 15
MAY 2015
A Publication for Community Care Providers
by the Agency for Integrated Care
EDITOR’S NOTE
2
May 2015
WELCOME TO mosAIC...
REFRESHED!
It is our first issue for 2015. Thank you for sharing your feedback on how this
newsletter can be more interesting and relevant to you. In this refreshed edition,
we are pleased to inform you that we have increased the content and added
new sections in not one, not two, but four additional pages.
As the ILTC sector makes strides towards achieving better quality care, foremost
on the minds of nursing home service providers is the Enhanced Nursing Home
Standards (ENHS). In Bulletin, you can refer to and make use of the courses and
new resources that are available to help you in your preparations.
In response to your request to better understand the work of fellow ILTC
healthcare staff, we have revamped Spotlight to bring you a glimpse into their
typical workday. For starters, Hariati Bte Sahak, Nurse Clinician at Home Nursing
Foundation and Adeline Quok, Senior Care Associate at TOUCH Community
Services, share the joys and challenges of attending to their homebound clients.
It was a pleasure to have met many of you at the ILTC Quality Festival and
inaugural National Seminar on Productivity in Healthcare (9 and 10 October
2014). Relive the event’s highlights in Showcase! Following the success of last
year’s inaugural ILTC Excellence Awards, AIC will be organising the next award
ceremony in 2016, with the nomination process starting in June 2015. Do
recognise your outstanding staff and turn to page 13 for more information on
how to participate.
Everyone wants to perform their best, especially when faced with difficult
situations. Get tips on how to communicate better from the bestselling book –
Crucial Conversations: Tools for Talking When Stakes are High – in
Improvements.
In this edition of Newsbytes, we feature the efforts of the ILTC Nutrition
Movement, initiatives such as a centralised transportation pilot for centre-based
services, the ILTC Personal Protective Equipment (PPE) stockpile initiative,
updates from the industry-led ILTC Manpower Council as well as provide tools to
help you better understand clients’ wellbeing. Do also check out updates on the
work in the community mental health arena in Care In Mind and the efforts of
peers in Sector’s Sharing. For an international view of care improvements, turn to
Regular Reads to learn about the strategy that England’s National Health Service
has implemented.
Lastly, we invite you to put your knowledge to the test by taking part in the quiz
on page 15. Shopping vouchers await winners.
We hope you will enjoy the refreshed mosAIC. Till the next issue, happy working!
Lynda Soong
Lynda Soong
Chief, Community Care Development Division
mosaic@aic.sg
mosAIC is the recipient of two APEX Awards for Publication Excellence – Most Improved
Newsletter category (2014) and Newsletter – Electronic and Web category (2013).
About Agency for
Integrated Care (AIC)
Agency for Integrated Care (AIC) seeks to create a
vibrant Care Community enabling people to live well
and age gracefully. AIC coordinates and facilitates
efforts in care integration to achieve the best care
outcomes for our clients. We do this by empowering
them with health and social care information and
arranging for their care when they are discharged
from hospitals. We enable stakeholders to raise the
quality of care, and also enhance collaboration by
working with health and social care providers to
increase services to support the ageing population.
Our work in the community brings care services and
information closer to those in need.
For more information, visit aic.sg.
About mosAIC
mosAIC shares happenings within AIC and in the
community care sector.
For more information, visit aic.sg/mosaic.
Publisher
Designer
Chief Editor
Printer
Agency for Integrated Care
Lynda Soong
Cubiz Pte Ltd
Spectrum Zone
International Pte Ltd
Second Editor
Charmaine Tan
MCI (P) 136/04/2015
mosAIC is a publication by the Agency for
Integrated Care (AIC). The views and opinions
expressed or implied in mosAIC do not necessarily
reflect those of AIC, its directors or editorial staff. All
information is correct at time of printing. Articles
may not be reproduced without AIC’s permission.
For editorial queries, feedback and subscription*,
please email mosaic@aic.sg
*Health and Social Care staff subscribe
for FREE!
Scan mosAIC’s Quick
Response (QR) code with your
smart devices to easily access
online content (flipzine,
photo/video gallery and
additional journal articles).
The new series of cover images
depict the impact that individuals
can make when they give their
best.
In this issue, the image shows a
single water droplet. Though just a
tiny drop of water, it has, like any
individual, the potential to make a
positive impact on its surroundings.
In support of a sustainable planet, this publication
is printed on environmentally friendly paper.
BULLETIN
aic.sg/mosaic
ENHS: PROVIDING HOLISTIC
AND BETTER CARE
The Enhanced Nursing Home Standards (ENHS) will be implemented
and enforced across all nursing homes in Singapore by 2016. To assist
homes, AIC has been developing and providing ENHS-related training.
These courses focus on enhancing providers’ understanding of the
enhanced standards and how to translate them in their daily nursing home
operations and practices.
One such course conducted centred on Care Planning. A care plan
aims to help staff better manage residents’ health on a daily basis. It
includes details of their (i) clinical and rehabilitation treatment;
(ii) medication; (iii) dietary requirements; and most importantly,
(iv) residents’ input on their desired care outcomes. During training
sessions, staff also learnt how to use tools such as the Resident
Assessment Record and Nursing Care Plan to carry out comprehensive
residents’ assessments and evaluation.
By participating in Enhanced Nursing Home Standards-related training,
healthcare staff are able to improve their skillsets and provide better quality
care for residents. (Photo credit: Lee Ah Mooi Old Age Home)
As Then Kim Yuan, Administrator, Lee Ah Mooi Old Age Home,
observed, “The newfound knowledge has been
Fast Facts
effective in reducing admission assessment time,
ensures consistency in care standards and clearer
Care Planning Tip
communication in reporting and updating of our
residents’ conditions.” Merly Quinones, Senior Staff
• By reviewing existing forms and nursing care plans to develop a single Resident
Nurse, Bright Hill Evergreen Home, credited the
Assessment Record, processes can be streamlined as the document
engaging hands-on sessions as key to her learning.
centralises information and can be used during handovers, thus cutting down
“From the sessions, I learnt how to utilise various
documentation duplication.
daily nursing charts to enhance workflow for better
continuity of care for our residents… the chance to
ENHS Resources
make bedside case presentations using the forms
• Find out about relevant resources (e.g., funding, training, courses)
was also most useful,” she said. Kim Yuan added,
matched to specific ENHS sub-domains by downloading the ENHS Resource
“Having structured care plans that meet residents’
List from the AIC Learning Management System!
needs and goals enable care staff to work more
• To date, 40 new courses have been added to the suite of more than 90
productively and effectively towards administering
programmes offered by the AIC Learning Institute, providing 4,000 training
quality care that is in line with what residents desire.”
places to support nursing homes’ implementation of the ENHS.
Upcoming ENHS-related Courses
Course
Month
Facilities Management
Between May and June 2015 (1 run)
Emergency Preparedness
Between May 2015 and March 2016 (5 runs)
Care Planning
Between May and June 2015
(Subject to demand, email Pauline Ang to indicate interest)
ILTC Culinary Boot Camp Training
Between July and September 2015 (1 run)
Dignity of Care, Psychosocial
and Mental Health, Informed
Care and Use of Restraint
Details to be announced!
FOR MORE INFORMATION!
Visit the AIC Learning Management System at
https://lms.aic-learn.sg/lms/app/SYS_login.aspx to
sign up for courses and to get the latest ENHS resources.
Contact
Indra Ali
6603 6855 / indra.ali@aic.sg
Pauline Ang
6632 1098 / pauline.ang@aic.sg
Ho Bee Kien
6603 6974 / bee.kien.ho@aic.sg
More photos at:
aic.sg/mosaic/gallery/may15
3
SPOTLIGHT
4
May 2015
A DAY IN THE
LIFE OF…
In this revamped section, we catch up with
health and social care staff to get a glimpse
of a day in their work lives. In this issue, we
feature two home care staff – Adeline Quok,
Senior Care Associate from TOUCH
Community Services - TOUCH Home Care
and Hariati Bte Sahak, Nurse Clinician,
Home Nursing Foundation.
9.00am
My workday begins by looking through the day’s schedule. I note down the required
services and pack the necessary supplies. As my clients typically require personal care
(maintenance exercise, basic health monitoring, administrative work, etc.), personal
hygiene or housekeeping services, items like gloves, aprons and a blood pressure
machine are indispensable. I also look through their latest case notes so that I can better
anticipate their needs and maximise our time together.
11.00am
Name:
Adeline Quok
Organisation:
TOUCH Community
Services –
TOUCH Home Care
Designation:
Senior Care Associate
Years in Service:
1 year and 2 months
(Photo Credit: TOUCH Community Services)
We are delighted to have ITE
graduates like Adeline join TOUCH
Home Care. With her specialisation in
Community Care and Social Service,
she is equipped with relevant
eldercare knowledge and training. Her
youthful personality and refreshing
service delivery approach have also
added value to the work we do in
helping frail elderly live with dignity in
the comfort of their homes.
I am usually on the way to my client’s home by this time. On average, I spend about 45
minutes to an hour in each home. Besides providing the requested services, I also make
it a point to catch up with clients. I enjoy this aspect of my job because I have always
been fascinated with people’s life stories. Being able to converse in dialect really helps
build rapport and many clients have shared very personal information like their courtship
days and the hardships they endured during the war. This time together is precious as it
helps us get to know each other better.
2.00Pm
Working as a Senior Care Associate is interesting as it involves varied tasks. In the
afternoons, I may accompany clients to run errands such as buying groceries. I know
they look forward to a little time away from home as I can sense their excitement even
as we get ready. Being able to bring such joy really gives me job satisfaction.
Working with elderly clients also requires vigilance. Once, a client fell down and I was the
only one around to assist her. After ringing the ambulance, I had to keep her calm while
we awaited further help. During times like these, I could see how my prior training in
Community Care and Social Service helped shape my reactions so that I could respond
effectively. Knowing that my team was just a call away also gave me great confidence.
6.00Pm
My workday is done after visiting five clients. I return to the office and hand over
outstanding cases to my other teammates. Sometimes, my supervisor and I will also do
a debrief about the day’s cases.
– Kavin Seow, Director,
TOUCH Home Care and TOUCH
Caregivers Support
Adeline accompanies me to buy
groceries, for my haircuts and also
helps keep my home clean. I’m
grateful for this support as I have weak
legs and can seldom go out on my
own. It feels so good to step outside
and breathe fresh air!
– Yeong Fong Ngan
Adeline is proud that her work supports the needs of frail elderly so that they can continue to live in their
homes. (Photo Credit: TOUCH Community Services)
aic.sg/mosaic
Name:
Hariati Bte Sahak
Organisation:
Home Nursing
Foundation (HNF)
Designation:
Nurse Clinician
Years in Service:
20 years in Nursing, 3 years with HNF
Awards received:
ILTC Excellence Award 2014 – Service
Quality (Silver); Nurse of the Year 2013,
Rotary Club of Jurong Town and HNF
(Photo Credit: Home Nursing Foundation)
8.00am
My workday begins. Twice a week, I attend
in-service lectures and multi-disciplinary
round-tables. At the round-table, together
with doctors, nurses and medical social
workers, we discuss complex cases. These
sessions help me increase my knowledge
and work better with other healthcare
professionals since I am more familiar with
their approaches.
9.00am
I prepare for the day and check my bags to
ensure I have the necessary medical
supplies. I also contact patients to remind
them about my visit. On average, I attend to
about seven to eight patients a day. This
time is also used to check in with my team
nurses, to discuss and guide them on their
more complex cases.
11.00Am
I make my first house call – rain, shine or
haze. On average, I spend about 30 minutes
to an hour with patients. If the patient is new
to us, I will perform a comprehensive
assessment to better understand their
needs. For regular visits, these will include
nursing procedures like wound dressing,
changing of feeding or catheter tubes, etc.,
and also training of caregivers.
Attending to patients at home makes every
session unique. Community nursing requires
resourcefulness. For instance, some
patients’ families believe that wounds are
dirty or infectious. Hence, wound dressing
Hariati is compassionate and
conscientious and carries out her
work with enthusiasm and
passion. Not only does she try her
best to understand patients’
needs, she also links them up to
resources and other service
providers so that they receive
seamless care in the community.
– Chan Mei Mei,
Director of Nursing,
Home Nursing Foundation
must be done outside the home,
sometimes even in the void deck.
Respecting my patient’s request, I do my
best to ensure we have a safe and private
environment to care for their medical
needs. I also encounter elderly patients
who have impairments, which make it
difficult for them to manage their home.
This poses a challenge too because we
need a clean environment for our
procedures. When there are situations of
potential hazard or harm, I will contact the
nearest town council or family service
centre for assistance.
Besides these, I also encounter clients with
financial difficulties. To minimise costs, I will
then resort to primitive but safe methods,
such as boiling receptacles and forceps, so
that items are kept sterile and can be reused.
The fortnightly visits by Hariati have given
me a feeling of security. My diabetic
condition has improved and I am no
longer admitted to the hospital
frequently. Hariati is patient and spends
time reminding me about the things that
I should do, including nagging me to be
compliant with my medication!
– Sukri Bin Abdullah
have financial difficulties which impact
their health, I will also enquire and match
them with relevant financial assistance
schemes.
6.00Pm
My workday ends and I return home. I am
blessed that my lovely husband and three
children are supportive and proud of my
profession. They are also accommodating
when I receive work calls after duty
hours. These are oftentimes from
caregivers requiring advice or a shoulder
to cry on. The ability to alleviate my
patients’ or caregivers’ anxieties and give
them confidence always makes my day.
3.00Pm
I return to the office having visited all my
patients for the day. This is when the
second aspect of my job begins. After
updating their case notes, I look into ways
to address their additional needs. Not all
issues can be solved within healthcare. For
instance, a depressed client who is not
compliant with medication may benefit from
being linked with a befriender. Knowing
someone cares can help them feel happier
and hence more willing to take their
medication. I then collaborate with other
health and social care professionals to
make the links. Other times, when patients
5
Hariati attending to a client and performing
nursing procedures such as wound dressing.
(Photo credit: Home Nursing Foundation)
More photos at:
aic.sg/mosaic/gallery/may15
SHOWCASE
6
May 2015
ENHANCING CARE THROUGH
QUALITY AND PRODUCTIVITY
using evidence-based medicine to stop
unnecessary medication use, testing and
procedures; and engaging patients in
decision making (e.g., Open Notes,
Advance Care Planning, lifestyle choices,
medication adherence, etc.).
(Left) Dr Steven Strongwater, Geisinger Health System, USA, sharing from his vast experiences about
improving healthcare operational efficiencies to improve patient care.
The ILTC Quality Festival is a signature
event that supports the sector’s efforts in
promoting and sustaining a culture of
quality improvement (QI). In 2014, the
Festival was jointly organised with the
inaugural National Seminar on Productivity
in Healthcare. Held between 9 and 10
October at the Singapore Expo Convention
and Exhibition Centre, the theme was
“Enhancing Care through Quality and
Productivity”. It was attended by over 1,000
health and social care participants.
The event was a good time of sharing and learning
for participants from the health and social care
sectors.
Key highlights included:
• Sharing sessions by local and
international thought leaders such as
Dr Steven Strongwater1, Stuart Smith,
Cynthia Payne, and Associate Professor
Pang Weng Sun;
• A productivity showcase of over 40
projects that have improved care
provision at various community care
organisations, healthcare institutions and
educational institutions;
At the ILTC Quality Festival the next day,
Parliamentary Secretary for Health and
Transport, Associate Professor Muhammad
Faishal Ibrahim highlighted the notable
efforts made in improving the sector’s care
quality. Evidence of this could be seen from
the 75 per cent increase in the number of
submissions made to the ILTC Quality
Festival Poster Competition, which
showcases good QI projects and an
encouraging number of entries submitted
for the inaugural ILTC Excellence Award.
• The launch of the inaugural ILTC
Excellence Award, where individuals/
organisations were recognised for their
outstanding contributions to the sector; and
• Breakout sessions, where participants
benefited from interactions with inspiring
speakers who touched on a wide range
of productivity and QI-related topics
including telehealth, business excellence,
technology, psychosocial care, and
designing better care processes to
enhance overall patient experience.
Setting the stage about the event’s
importance, Minister for Health, Gan Kim
Yong, in his opening speech at the National
Seminar on Productivity in Healthcare,
emphasised the need to raise healthcare
productivity to improve operational efficiencies
and positively impact patients’ care.
Elaborating on his organisation’s efforts in
this area, plenary speaker, Dr Steven
Strongwater discussed his experiences in
reviewing innovations and process
transformation initiatives to improve patients’
experiences and care at reduced costs.
Initiatives included improving care
organisation (e.g., Setting timely reminders
for physicians and patients, after hours care);
Amy Lim Sock Hui, HCA Hospice Care, receiving the
ILTC Excellence Award – Service Quality (Gold) from
Associate Professor Muhammad Faishal Ibrahim,
Parliamentary Secretary for Health and Transport.
Amy Lim Sock Hui, Assistant Nurse
Manager, HCA Hospice Care, one of the
eight Service Quality (Gold) recipients
honoured during the ILTC Excellence Award
ceremony, said, “This award is for all who
have partnered me in this journey and the
highest acclamation goes to patients who
have generously shared their most trying
and intimate moments with me. The elation
of working in the ILTC sector is
measureless; the hard work, stress and
responsibility is just as boundless. Service
quality means looking deep, exploring
creatively and not missing out on any
opportunity to make a difference and a
aic.sg/mosaic
7
positive impact to the patient’s quality of life. My palliative nursing journey has entered a
new era with this award.”
This year’s gold award for the ILTC Quality Festival Poster Competition went to Bright
Vision Hospital (BVH) for their project which has improved clients’ admission process to
their Day Rehabilitation Centre (DRC). Yong Limin, Rehabilitation Manager, BVH, shared,
“This initiative came about during a discussion between our doctor and senior therapist
during a multidisciplinary team meeting. Providing quality care is not only from the care
intervention itself but can also be from better managing related processes. We are happy
that this initiative has facilitated timelier and more efficient access to our DRC. We are so
encouraged and honoured to win this award.”
Bringing the event to a memorable
close, Associate Professor Pang Weng
Sun, shared about the importance of
Advance Care Planning in the journey of
providing quality care. He emphasised
the need to start the conversation early
so that family members and healthcare
staff would have a good understanding
of clients’ values and beliefs about their
treatment choices. He also highlighted
the important role healthcare
practitioners play in assisting clients and
their families to have good closure by
Associate Professor Pang Weng Sun, Yishun Community
Hospital, sharing about the important role of Advance Care helping them develop positive images of
Planning in helping clients and their loved ones have good their loved ones in the final stage of their
closure.
life journey.
‘Gold’ poster award recipients (back row, L-R)
Shahidah Rustam Ali, Admin Assistant; Chia Gek
Luang, Senior Patient Care Assistant; Yong Limin,
Rehabilitation Manager; (front, L-R) Lee Shu Hui,
Senior Occupational Therapist; Anne Chong Lai
Yong, Admin Assistant (Mong Yiqin, Senior
Physiotherapist and Dr Tan Shu Yun, not in picture).
(Photo credit: Bright Vision Hospital)
Fast Facts
ILTC Quality Festival and National Seminar on Productivity in Healthcare
• The first ILTC Quality Festival was held in 2011.
• 2014 was the inaugural year of the National Seminar on Productivity in Healthcare and the ILTC Excellence Awards.
• The ILTC Excellence Awards comprise three categories – Service Quality; Good Suggestion; and Good Practices (Areas: Clinical
Quality, Service Quality, Productivity and Innovation) and more than 200 exemplary ILTC staff/project teams were recognised. (Turn to
page 13 for information about the next Awards taking place in 2016.)
• The ILTC Poster Competition received a total of 92 abstracts from 16 organisations.
• The event was organised by MOH and AIC with the support of Assisi Hospice, Bright Vision Hospital, Econ Healthcare Group,
Employment and Employability Institute, Jurong Health Services, Khoo Teck Puat Hospital, Moral Home for the Aged Sick, Mount
Elizabeth Hospital, National University Hospital, NCS Pte Ltd, NTUC Health Co-Operative Ltd, Ren Ci Hospital, Serene/Irene
Nursing Home, SWAMI Home, Tai Pei Social Service and Tan Tock Seng Hospital.
Dr Steven Strongwater is the Chief Transformation Officer of Geisinger Health System, USA; Stuart Smith is the Chief of Service Innovation Practice, Institute of
Systems Science, National University of Singapore; Cynthia Payne is the CEO of SummitCare, Australia; and Associate Professor Pang Weng Sun is the Chairman,
Medical Board, Yishun Community Hospital, Senior Consultant, Department of Geriatric Medicine, Khoo Teck Puat Hospital and Vice Dean, Clinical Affairs, Lee Kong
Chian School of Medicine, Nanyang Technological University.
1
FOR MORE INFORMATION!
Visit aic.sg/healthcareproductivity_qualityfestival/ to view selected speakers’
notes and posters.
More photos at:
aic.sg/mosaic/gallery/may15
IMPROVEMENTS
8
May 2015
CRUCIAL CONVERSATIONS:
TOOLS FOR TALKING WHEN
STAKES ARE HIGH
During face-to-face conversations, we often don’t have the luxury to think through our
responses fully before answering. What we may then deem appropriate at that juncture
may, in retrospect, be managed better.
In the bestselling Crucial Conversations: Tools for Talking When Stakes are High, authors
Kerry Patterson, Joseph Grenny, Ron McMillan and Al Switzler offer readers five tips to
improve the efficacy of crucial conversations – discussions when stakes are high, opinions
vary and emotions run strong.
Tip
#1
Learn to Spot Hostile
Conversations
When involved in a hostile conversation,
people may adopt a “silent” or “violent”
stance. Signs of this include understating or
selectively showing true opinion, use of
sarcasm, forcing views on others,
dominating the conversation, and labelling
people or ideas under a general stereotype
or category.
Knowing how to spot these signs, both in
yourself and others, can help keep
conversations on course.
Tip
#2
Define Clear
Objectives
Typically, crucial conversations occur to
resolve or mitigate problems. It is therefore
important to identify, prior to the discussion,
the motivation for this dialogue, the
perspectives of parties involved, as well as
the desired outcomes. This paves the way
for finding mutually beneficial resolutions and
prevents discussions from becoming awry.
Tip
#3
Craft Objective
Stories
Before the dialogue begins, gather facts
about the issue and construct your story.
Avoid portraying yourself as the victim and
the other party as the villain. Bear in mind
that these stories can affect how you feel,
and in turn, how you act. Basing your story
on facts and statistics rather than personal
opinion also enables your case to be
considered more seriously and favourably,
helping you achieve your desired results.
Tip
#4
Create Safe Conditions for
Crucial Conversations
As you enter the conversation, aim to put
other parties at ease by focusing on or
creating mutual purposes. Start by sharing
facts, avoiding personal opinions, then
explaining how the facts led to your
summation. Finally, invite other parties to
share their views. Parties may maintain the
conversation by continuously showing
mutual respect.
Tip
#5
Know How to Make
Decisions and Assign Tasks
Remember that crucial conversations are
not considered decision-making processes.
When the discussion is over, if necessary,
establish the next course of action. Decide
who should be responsible, how the task
should be done, as well as the deadline.
Highly insightful, this book empowers
readers with skills to enhance professional
and personal relationships. For instance,
knowing how to hold such crucial
conversations in healthcare may help
improve patient safety, reduce staff turnover
and increase efficiency.
Watch Joseph Grenny explain
more about Crucial Conversations
at goo.gl/4NjOMI
How do you react under stress?
Find out at goo.gl/pI0Okc
NEWSBYTES
aic.sg/mosaic
BULK COOKING
TRAINING
The ILTC Nutrition Movement aims to
heighten awareness about the importance
of good nutrition and food service in the
ILTC sector through:
• Capability building (training);
• Information and resources (recipe
inserts, posters); and
• Awareness building initiatives (Hawker
S.E.D.A.P Cook off, etc.).
NUTRITION
HIGHLIGHT
To enhance ILTC cooks’ skillsets, bulk
cooking training sessions were organised
in November and December 2014. In
collaboration with the Health Promotion
Board (HPB), they were conducted by
professional chefs from SATS – an
integrated service provider of food
solutions and gateway services – at SATS
Inflight Catering Centre 1. It was attended
by 35 cooks from 22 ILTC organisations.
What they learnt:
• Basics of bulk cooking: Planning kitchen operations for bulk
cooking and various ways to provide healthy diets for elderly clients.
APPLY
TODAY!
QUICK BYTES
Tote Board Community
Healthcare Fund (TBCHF)
Application
Closing Dates
Project
Commencement
• 31 July 2015, 5pm
• 1 November 2015
• 30 November 2015, 5pm • 1 March 2016
• 31 March 2016, 5pm
• 1 July 2016
• Hands-on practice sessions: Preparing healthier versions of Chinese recipes. Recipes
enhanced in collaboration with HPB included:
- Fried Kway Teow;
- Steamed Chicken Thigh with Cloud Fungus and Ginger and Fragrant Rice;
- Sauteed Sliced Chicken Breast with Beancurd in Yellow Bean Sauce and Fragrant Rice;
- Steamed Egg Tofu with Minced Chicken and Water Chestnut; and
- Red Cargo Rice and Vegetables.
FOR MORE INFORMATION!
Visit aic.sg/tbchf or contact the
TBCHF Secretariat at
tbchf@aic.sg or 6593 3946.
ILTC cooks being briefed before their practice session where they prepared healthier versions of Chinese recipes.
FOR MORE INFORMATION!
Visit www.aic-learn.sg/nutrition-facts to get access to recipes, nutrition
posters and other resources or contact Pauline Ang at pauline.ang@aic.sg.
9
More photos at:
aic.sg/mosaic/gallery/may15
NEWSBYTES
10
May 2015
EYES AND EARS
IN THE COMMUNITY
CARE
IN
MIND
Sign Up for
Mind Matters is a bite-sized bi-monthly electronic bulletin
that supports community mental health partners in
developing a better understanding of various
programmes, initiatives and resources in the community.
Dr Tan Weng Mooi, Chief, Community Mental Health Division, AIC, (centre, in
turquoise), facilitating a Local Community Support Network meeting, where
different agencies collaborate to link residents with more complex needs to
appropriate resources and services for early intervention.
An 80-year-old lady gave feedback to Kembangan-Chai Chee
grassroots volunteers that neighbours had thrown oil against her
window. Upon visiting her, no sign of oil was found but it was noted
that she seemed incoherent and that her living environment was dark
and messy.
Suspecting something was amiss, her situation was flagged by the
volunteers as a case to seek advice and support from the Local
Community Support Network (LCSN).
The LCSN:
• Aims to provide holistic care to residents through the
integration of mental health, physical health and social care services;
• Discusses residents who have more complex needs and how
best to link them to appropriate resources and services for
early intervention; and
• Is attended by multi-agency representatives from AIC; Institute
of Mental Health (IMH); restructured hospitals; social service
agencies; Housing and Development Board; town councils; and
other agencies.
After hearing about her case, the LCSN advised social workers to visit
the lady and ascertain if she had mild dementia, which may have been
triggering delusions.
Aside from the Kembangan-Chai Chee constituency, AIC has also been
working with other constituencies and community partners to raise
their mental health awareness and empower them to recognise and
support residents who may have or be at risk of mental health issues.
Read the latest issue at careinmind.aic.sg/mindmatters
or contact careinmind@aic.sg to subscribe for free!
Macam Macam
Market
Visit the
Macam Macam Market
in Institute of Mental Health (IMH) every
first Sunday of the month!
With some recovering clients facing challenges with
employment, this flea market provides an avenue for them
to run their own small business and generate some pocket
money. The market sells pre-loved or brand new items
such as books; clothes; bags; and handmade crafts such
as paintings, etc.
Contact IMH at enquiry@imh.com.sg
for more information.
(Photo credit: IMH)
FOR MORE INFORMATION!
Contact Elaine Soh at elaine.soh@aic.sg for mental
health-related programmes.
aic.sg/mosaic
CENTRALISED TRANSPORT PILOT ROLLS OUT!
Access to eldercare services can be an issue, especially for elderly who are less mobile. To
address this, in January 2015, AIC began a two-year transportation pilot project in
partnership with the Handicaps Welfare Association (HWA).
11
CARERS
CORNER
Through this initiative, HWA acts as a centralised operator providing transportation to clients
in daycare facilities such as Day Rehabilitation Centres, Day Care Centres, Dementia Day
Care Centres and Senior Care Centres in the Central Regional Health System (RHS) area*.
Expected benefits include:
• Increasing the number of clients who will be able to access centre-based services;
• Reducing transportation costs for clients; and
• Cutting down on the administrative work related to transportation arrangements
such as route planning, driver recruitment, etc.
SPD@Toa Payoh, was the first centre to come on board with 10 clients signing up for the
service. Abhimanyau Pal, Executive Director, SPD, said, “Transport and accessibility are
important in the rehabilitation of persons with disabilities. We are happy that AIC is piloting
this much-needed scheme to enable us to serve more people in the community.”
(L-R) Sharon Chen, Centre Head,
SPD@Toa Payoh and Subrata Banerjee,
Executive Director, Handicaps Welfare
Association, kick off their partnership through the
Centralised Transport Pilot project.
With the inclusion of HWA’s vehicle fleet, coupled with better efficiencies and vehicle
utilisation brought about by this centralised deployment model, transport capacity for this
region is expected to increase significantly.
FOR MORE INFORMATION!
Contact Wong Pui Leng at
pui.leng.wong@aic.sg
or 6593 3901.
*The Central RHS area covers Ang Mo Kio, Bishan, Serangoon, Hougang, Toa Payoh, Geylang, Kallang,
Rochor and Novena.
PPE STOCKPILE FOR THE ILTC SECTOR
have infection control, crisis response and
surveillance procedures; implement a
robust service continuity plan; and maintain
an adequate supply of Personal Protective
Equipment (PPE) items to protect
healthcare staff during a pandemic period.
To support the sector’s efforts, MOH has
built an ILTC PPE stockpile to ensure
adequate sector-wide response. The ILTC
PPE stockpile comprises four main items:
Healthcare staff improving their knowledge about
Personal Protective Equipment to ensure that they
are ready to respond during a pandemic.
Under the Ministry of Health’s (MOH) best
practices and guidelines, all healthcare
providers are required to remain vigilant
against pandemic outbreaks. ILTC
providers therefore have to ensure they
FOR MORE INFORMATION!
• N95 masks;
• Surgical masks;
• Isolation gowns; and
• Examination gloves.
AIC will work with MOH to manage and
coordinate the ILTC PPE stockpile for
eligible organisations including:
• Voluntary Welfare Organisation (VWO)
Community Hospitals;
• VWO Nursing Homes and Private Nursing
Contact William Loh at william.loh@aic.sg or 6632 1177;
or Indra Ali at indra.ali@aic.sg or 6603 6855.
Homes with Portable Subsidy;
• VWO Hospices;
• VWO Dialysis Centres;
• VWO Home Care and Palliative providers;
• VWO Psychiatric facilities; and
• VWO Centre-based providers who are
MOH subvented.
ILTC providers will only need to pay for the
cost of usage upon drawdown, which
includes the cost of PPE items at the
prevailing rate and distribution/
transportation cost.
The stockpile does not negate the
requirement for providers, such as Nursing
Homes and Community Hospitals, to
maintain at least one week’s supply of PPE
items onsite during a crisis, as mandated
under section 6(5) of the PHMC Act (Cap
248) – Maintaining a Supply of Personal
Protective Equipment for Use during Public
Health Emergencies.
More photos at:
aic.sg/mosaic/gallery/may15
NEWSBYTES
WE WANT YOUR
SUBMISSIONS!
12
May 2015
Share your initiatives and stories with mosAIC readers! For more information, contact Charmaine Tan at
mosaic@aic.sg.
UNITING AS ONE TO
IMPROVE RESIDENTS’
QUALITY OF LIFE
SECTOR ’S
SHARING
YOU CAN CONTRIBUTE
IN MANY WAYS!
Contributed by Sally Benjamin, Comfort Keepers
Contributed by Ren Ci Nursing Home
Nursing homes provide the elderly with high levels of nursing care and
opportunities to reach optimal level of functioning. However, practices
can sometimes reflect a lack of diversity and integration of recreational
services. To address this, Ren Ci’s rehabilitation department developed
the “ONE Program”.
Led by Christopher Ng, Rehabilitation Manager, and three senior
therapists, the programme aims to develop a structured,
cross-department and multi-disciplinary effort to increase the variety of
meaningful activities for Ren Ci Nursing Home’s residents, thus
improving their quality of life.
Christopher said, “There are
two interpretations on
why we use ‘ONE’ in our
project name… from the
residents’ perspective, it is
seen as one continuous
programme; for staff, it is
about coming together as
one to engage residents.”
Through a redesign of
manpower, such as the
pooling and sharing of
resources (including
volunteers and nurses) in
The ONE Program includes leisure activities
the running of the
across four categories such as arts and craft, programmes, the home is
social/recreation, physical and cognitive.
now able to regularly facilitate
(Photo credit: Ren Ci Nursing Home)
leisure activities across four
categories: arts and crafts, social/recreational, physical and cognitive. To
ensure residents enjoy maximised benefits, they are grouped according
to their areas of interest, physical abilities and medical conditions.
Activities offered range from mural painting and baking to ball games
and solving jigsaw puzzles.
After implementation, resident engagement has increased from two to
nine activities in a week, a 350% increase. Besides building a
community within the nursing home, the programme has also improved
participating residents’ mood, relieved their boredom, and fostered
camaraderie through their increased interaction with each other.
This programme garnered the Excellence Award in the Human Resource
Development category at the Asian Hospital Management Awards
(AHMA) 2014, beating entries from 82 other hospitals and healthcare
organisations. It also won the Best Poster Award at the Singapore
Rehabilitation Conference 2014.
As part of her work at Comfort Keepers, Sally is involved in giving
talks and sharing at other platforms to assist caregivers.
(Photo credit: Comfort Keepers)
I joined Comfort Keepers as a caregiver in 2011. Prior to
that, my working experiences had been in customer service
and human resource. I didn’t have any medical or nursing
experience but had formerly been a caregiver for my late
mother who had dementia. I had also attended a
non-medical caregiving course in the United States.
In many ways, I am no different from the many caregivers at
Comfort Keepers. We come from varied backgrounds – from
former homemakers with grown up children to men seeking
a mid-career change. However, what binds us all is our want
to make a difference in the lives of others.
What I enjoy most about my job is its many facets. It is not
solely about providing care and companionship to clients. I
also advise them and their families about the existence of
important matters like Advance Medical Directives and the
role of a Lasting Power of Attorney so they can plan ahead.
Another aspect that I often discuss with families is about
addressing the misconception that they must attend to and
serve every single need of a client. Instead, I share about the
importance of supporting clients so that they are as
independent as possible, for as long as their health allows.
This has a positive effect not only on their physical but also
mental and emotional wellbeing.
These days, my job focuses more on public relations, as the
big, strong and friendly face of Comfort Keepers. In the
media, conferences and community events, I share about
the services we provide (which range from respite care to
end-of-life) and also my experiences as a caregiver. By
sharing and discussing the resources available now, I hope
families will feel better supported and know where to turn to
so that they won’t feel so alone.
aic.sg/mosaic
13
NTUC HEALTH PRESSES ON IN
ITS PRODUCTIVITY JOURNEY
Contributed by NTUC Health
NTUC Health, the new entity formed with
the integration of Unity Healthcare and
NTUC Eldercare, was one of AIC’s first ILTC
partners to embark on a formal productivity
training programme for staff.
Conducted between February and
September 2014, the programme
comprised Basics of Productivity, Certified
Productivity Practitioner (CPP) and
Productivity Day. It saw 23 staff from NTUC
Health’s various eldercare services (Home
Care, Senior Care Centres, Senior Activity
Centres, and Sheltered Home) attend
sessions that were led by the Singapore
Productivity Association. The programme’s
centerpiece was the CPP session, which
taught staff tools and techniques to
improve workplace productivity. It is
accredited by the Asian Productivity
Organisation and supported by Singapore
Workforce Development Agency.
Rounding off the training was NTUC
Health’s first Productivity Day on 30
September 2014, where staff presented
their projects showcasing the methods and
techniques learnt (Plan-Do-Check-Action
and 5S*), to NTUC Health’s CEO and
management team. The winning project
focused on ways to serve more home care
clients by optimising staff productivity
through better workflows and inter-team
communication. Team members used
surveys and interviews to first identify
current inefficiencies and their causes
before proposing new ideas and carrying
them out. Other good project ideas
presented included improving the
management of donated items, improving
payment efficiency for clients, and
incorporating good workspace
housekeeping.
Desmond Lem from the winning project team
shared, “The programme was beneficial. It
taught us ways to identify underlying
problems, gave us tools to envision the
bigger picture and therefore, enabled us to
be more productive in our work.”
Pang Sze Yunn, Head of NTUC Health’s
Home Care services and also the
programme lead, added, “We were keen
to equip our middle management staff
with skills to refine business processes so
that we can be more efficient. In the long
run, we hope to build a continuous
learning culture where staff feel
empowered to exercise more initiative and
creativity to improve both customer and
staff experience.”
Are you capturing notes of appreciation/compliments
from clients and their families about your staff?
Are you recognising staff for their excellent service and
keeping track of the awards they receive?
START NOW!
We want your nominations for ILTC Excellence Awards 2016!
The call for nominations begin in June 2015 and
will close on 31 January 2016.
Visit aic.sg/excellenceawards to find out more!
(L-R) Chua Song Khim, CEO, NTUC Health,
presenting a prize to Kelly Han and Desmond Lem
for their winning project, which better utilises staff
through new workflows and inter-team
communication to serve more home care clients.
(Photo credit: Courtesy of NTUC Health)
*5S is a structured process to systematically
achieve a well-organised, clean and standardised
workplace that results in higher safety, efficiency and
productivity. It is abbreviated from Sort, Straighten,
Shine, Standardise and Sustain.
More photos at:
aic.sg/mosaic/gallery/may15
NEWSBYTES
14
May 2015
EMBRACING THE ARTS TO
IMPROVE RESIDENTS’ CARE
Contributed by Villa Francis Home for the Aged, Society for the Aged Sick and Sree Narayana Mission Home for the Aged Sick
recreational programmes.
Staff from three nursing homes travelled to
Melbourne, Australia to learn more about the field of
Arts and Health and to visit aged care sites.
In November 2014, staff from Villa Francis
Home for the Aged (VF), Society for the
Aged Sick (SAS) and Sree Narayana
Mission Home for the Aged Sick (Sree)
attended the 6th International Arts and
Health Conference, in Melbourne, Australia.
They also visited aged care facilities, where
they observed and participated in
“It was an eye-opening conference and
especially thrilling because we were there
to present findings from Everyday Waltzes
for Active Ageing, a creative movement
programme that was piloted at our home,”
said Jumir Cansino, Therapy Aide, VF. Her
colleague, Joanna Abellera, Nursing Aide,
shared, “We were really nervous about the
presentation but with the support of our
administrator, Sr Maria Sim and AIC, we
not only polished up our presentation but
were able to confidently present in front of
conference delegates. The support and
interest they showed in the programme
were really great.”
The opportunity to be immersed in learning
about arts and health projects both from
Australia and internationally has also been
beneficial. Jumir said, “I gained knowledge
and learnt new ideas in facilitating, such as
how to conduct reminiscence activities
involving music, stories and paintings.”
For Geraldine Lim, Nurse Manager, SAS,
the site visits were particularly useful. “It
was good seeing the actual programmes
being conducted and to speak to the
staff... we not only saw the programmes’
benefits but also how they were able to
manage without additional manpower.”
Bernadette Lee, Admin and Volunteer
Management Manager, Sree, shared,
“The homely environment we saw in the
nursing homes has enabled residents to
maintain their individual identity and
provided a good sense of belonging. It
was nice to see how the creative
activities carried out were so fun and
engaging and provided residents with
meaningful human connection.”
Summarising their experiences, Joanna
said, “After this visit, there is a better
appreciation for the arts as an important
tool in promoting health and wellbeing,
not only for the elderly but also for
everyone.”
NEED THERAPY SERVICES?
To meet the growing need for Allied Health
Professionals (AHPs) in the ILTC sector, a
third therapy hub – Mobile Rehabilitation
Services (MORE) – was formed in April 2014
by Asian Women’s Welfare Association
(AWWA) in collaboration with AIC.
the high standards we expect and carefully
selected professionals that were the best fit
for our organisation. The MORE therapist
we have is both well-respected and works
well with our staff in care planning for clients
as a part of the Apex family.”
MORE provides:
• Occupational, speech and
physiotherapy services;
• Supervision to ensure compliance with
AHP Act requirements;
• Training for support staff and
caregivers; and
• Comprehensive client rehabilitation
programmes.
Then Kim Yuan, Administrator, LAMH, said,
“Our residents are now more engaged in
their care, more committed to their treatment
plans and receptive of medical advice…
some are even surprised that they can still
stand up and walk for a while.” The additional
clinical guidance given to staff has also
inspired in them greater confidence in areas
such as transferring and lifting.
Two facilities partnering MORE are Apex
Harmony Lodge (AHL) and Lee Ah Mooi
Old Age Home (LAMH). Soh Mee Choo,
Chief Executive Officer, AHL, shared,
“MORE’s approach is synergy driven rather
than that of a vendor-customer relationship.
They sought to understand and embrace
Encouraging providers to consider similar
services, Kim Yuan said, “By looking
beyond reactive care to one that is more
proactive and preventive in nature, it will
lower care provision costs, maximise
residents’ care quality and may also result in
higher resident volumes and better returns.”
A MORE therapist leading group exercise with
residents from LAMH.
(Photo credit: Asian Women’s Welfare Association)
FOR MORE INFORMATION!
Contact Wang Yuhui or
Maheshwari, AWWA at
6511 5236.
aic.sg/mosaic
WE WANT YOUR
SUBMISSIONS!
Contact mosaic@aic.sg to announce new appointments to key
leadership positions in your organisation.
KEY APPOINTMENTS
IN THE SECTOR
Find out how leaders holding new positions hope to contribute to the ILTC sector.
Dr Ong Yew Jin, Medical Director,
Singapore Cancer Society (January 2015)
“I was training in emergency medicine when a personal
experience caring for a loved one spurred me to explore
palliative medicine. Thereafter, I worked at Assisi Hospice and
trained as a specialist in the field. Encounters with patients and
their families led me to realise the importance of caring for the
whole person (physical, practical and psychosocial needs) and
for a team and community to be involved in caring for the sick
at home. At Singapore Cancer Society, I am working towards
building an integrated and passionate team to continue to
address our clients’ home care needs. We are also looking
forward to the opening of our one-stop community-based
rehabilitation centre at JEM in September 2015.”
Karen Lee, Chief Executive Officer,
Home Nursing Foundation (November 2014)
(Photo credit: Home Nursing
Foundation)
“In my previous role at the Economic Development Board, I
was involved in the planning and development of Singapore’s
biomedical sciences industry. Subsequently, I joined the acute
care sector and worked in clinical operations. After witnessing
my grandmother’s health deteriorate in her final years, I
decided to join the ILTC sector as I felt that the sector would
need to considerably step up to support Singapore’s
caregiving needs, especially in light of the smaller families we
now have. At Home Nursing Foundation (HNF), I hope to
continue to build the depth, breadth and quality of our
services; forge partnerships with the Regional Health Systems
and social agencies; and expand our home care services. We
will also continue to fundraise to ensure no patient is left
behind because of financial difficulties. In the second half of
2015, we will launch our new home therapy service.”
Chan Mei Mei, Director of Nursing,
Home Nursing Foundation (August 2014)
TEST NEW!
YOUR WITS!
Take part and win
shopping vouchers!
Email your answers together with your
name, designation, organisation and
mobile number to mosaic@aic.sg with
the subject header “mosAIC #22 Quiz”.
Winners will be notified by email!
Questions:
1) What are some of the resources
available to assist nursing homes in
preparing for the ENHS?
a. ENHS-related Courses
b. Online resources such as Guides and
Lists
c. All of the above
2) Service Quality, Good Suggestion
and Good Practices are the three
categories of the ILTC Excellence
Awards.
a. True
b. False
3) Which four items are part of the
ILTC PPE stockpile?
a. N95 masks, Surgical Masks, Isolation
Gowns, Syringes
b. N95 masks, Surgical Masks, Isolation
Gowns, Examination Gloves
c. Surgical Gowns, Surgical Masks,
Isolation Gowns, Examination Gloves
Bonus Activity
you and
Capture a group photo of
with this
ting
rac
inte
s
your colleague
(i) what
us
tell
and
IC
sA
mo
issue of
ue
you liked about this iss
Sho
and (ii) how you think it
p
Vou ping
che
can be improved.
g
pin
op er
Sh uch
Vo
(Photo credit: Home Nursing
Foundation)
“I joined nursing in 1979 as I was influenced by my late
mother who felt that nursing is a respectable profession. After
serving in the acute care sector for many years, I decided to
join the ILTC sector because of the increased emphasis to
scale up and develop home care. Though community nursing
is different from the acute care environment, I felt that my skills
and experiences would be useful. At HNF, I plan to review the
current nursing model to support the care coordination
approach for all-round patient support; develop nurses’
capabilities in quality improvement and research, dementia and
palliative care; and enhance nursing operational efficiency by
reviewing key processes and leveraging information technology.”
15
r
the best entry will win an
her!
additional $20 shopping vouc
More photos at:
aic.sg/mosaic/gallery/may15
NEWSBYTES
16
May 2015
INTRODUCING THE ILTC MANPOWER
COUNCIL FOR 2015/16
Formed in April 2010, the industry-led ILTC Manpower Council
provides a common platform for ILTC institutions to collaboratively
improve and develop the sector’s workforce.
Roles and responsibilities of the Council include:
• Identifying issues and challenges faced in the ILTC sector;
• Making recommendations to resolve issues and/or make
improvements; and
• Promoting awareness, garnering support within the ILTC
sector and leading the sector to work collaboratively towards
new initiatives or changes.
In its third term (January 2015 to December 2016), the Council
comprises:
The ILTC Career portal (iltcareers.sg) is one of the many initiatives
spearheaded by the ILTC Manpower Council.
Chairpersons
Olivia Tay, Group Chief Human Resource
Officer, National Healthcare Group
Dr R Akhileswaran, CEO & Medical
Director, HCA Hospice Care
Loh Shu Ching, CEO, Ren Ci Hospital
S. Vivakanandan, CEO,
Ang Mo Kio-Thye Hua Kwan Hospital
(Attraction and Retention Taskforce2 Lead)
Council Members
Dr Ow Chee Chung, CEO,
Kwong Wai Shiu Hospital
Chern Siang Jye, Chief Corporate
Officer and Chief, Regional Engagement
& Integration Team (REIT) Division, AIC
Dr Khoo Chow Huat, CEO,
Orange Valley
Lynda Soong, Chief, Community Care
Development Division, AIC
Tan Li Li, Executive Director,
Singapore Association for Mental Health
Resource Panel Member
Victor Seng, Administrator,
St Theresa's Home
Phua Puay Li, Director,
Manpower Planning & Strategy, MOH
Tim Oei, CEO, Asian Women's Welfare
Association (Leadership Development
Taskforce1 Lead)
Pang Sze Yunn, Head,
Home Care Division, NTUC Health
(Attraction and Retention Taskforce2 Lead)
Aims of the Leadership Development Taskforce include: Strengthening and developing leadership competencies at the senior management levels and engaging and
involving leadership in sector initiatives.
1
Aims of the Attraction and Retention Taskforce include: Aligning sector strategies to recruit and retain suitably qualified and competent staff and enhancing the
attractiveness of work in the sector and to promote ILTC as an employer of choice.
2
ENHANCEMENTS TO CHAS AND SMF
Community Health Assist Scheme (CHAS)
• From 1 April 2015, elderly aged 65 and above can
use another $200/year from Medisave to pay for
outpatient medical treatment at public hospital
Specialist Outpatient Clinics, polyclinics and
participating CHAS clinics.
Seniors’ Mobility and Enabling Fund (SMF)
• From 1 April 2015, SMF provides
means-tested transport subsidy to seniors
requiring mobility assistance (not just
wheelchair-bound seniors) to attend
MOH-funded eldercare and dialysis centres.
• From 1 June 2015, four more chronic conditions –
Epilepsy, Osteoporosis, Psoriasis and Rheumatoid
Arthritis – will be covered under CHAS and Medisave.
FOR MORE INFORMATION!
Visit chas.sg or contact 1800-275-2427 (1800-ASK-CHAS).
FOR MORE INFORMATION!
Visit aic.sg/smf or contact
1800-650-6060.
aic.sg/mosaic
LIVING LONG BUT LIVING WELL?
HEALTH-RELATED QUALITY OF
LIFE TOOLS FOR ILTC
Background
The vision of Singapore’s integrated care
efforts is to enable the elderly to live well
and age gracefully in the community.
Good quality of life (QoL) is one of the
key targets for such efforts. While a wide
range of Health-related quality of life
(HR-QoL) tools are available, ILTC
providers often have difficulty choosing
appropriate ones for their care setting
(e.g., residential, centre-based) or target
population (e.g., dementia clients). The
QoL literature, although rich, does not
specify HR-QoL tools appropriate for the
sector. Three researchers from AIC
initiated a study to consolidate existing
evidence from published literature on
HR-QoL tools and create a taxonomy
which can be used in the sector.
Method
A systematic review of papers was
performed. Medline, Web of Science,
Proquest, EBSCO, Cochrane Library and
Google Scholar were searched by two
researchers who independently identified
eligible studies. The inclusion criteria were
that these studies: (i) Had a systematic
review focusing on QoL; (ii) Discussed
HR-QoL measurement tools; and (iii)
Referred to tools relevant to ILTC facilities.
Methodological quality of the review papers
was assessed by using AMSTAR (A
MeaSurement Tool to Assess systematic
Reviews). A quality checklist was also used
to appraise measurement properties of the
HR-QoL instruments, such as internal
consistency, reliability, content validity and
construct validity.
Table 1: Recommended HR-QoL Tools for the ILTC Sector
Clients' Conditions
Service
Setting
Assessor
Professional/
provider
Proxy/
caregiver
Self (client)
Generic –
for clients with
multiple morbidities
Home-based
5,8
1,8
1,2,4,5,6,7,8,9
Centre-based
5,8
1,8
1,2,4,5,6,7,8,9
1
1,2,3,4,6,7
Dementia –
for programmes
specifically for clients
with dementia
Home-based
11,13,14
Centre-based
11,14
11,14
11,12,14
10,11,14,16
11,14,16
11,12,14
Palliative –
for programmes
specifically for clients
receiving palliative care
Home-based
19
17,18
Centre-based
19
17,18
19,20
17,18,20
Residential
Residential
Residential
20
11,13,14,15 11,12,13,14,15
1: SF-36; 2: SF-12; 3: Kane et al.’s Psychosocial Quality of Life Domains questionnaire; 4: Nottingham Health
Profile (NHP); 5: Dartmouth Primary Care Cooperative Information Project (COOP) Charts; 6: Utility measure
EuroQol (EQ5D); 7: Sickness Impact Profile (SIP); 8: World Health Organization Quality of Life short version list
(WHOQOLBREF); 9: Functional Status Questionnaire (FSQ); 10: QUALIDEM; 11: Quality of life in Alzheimer’s
disease (QOL-AD); 12: Dementia quality of life (D-QOL); 13: Quality of life for dementia (QOL-D); 14:
Alzheimer’s disease related quality of life (ADRQL); 15: Cornell Brown Scale for Quality of Life (CBS); 16:
Dementia Care Mapping (DCM); 17: McGill Quality of Life Questionnaire (MQOL); 18: Quality of Life at the end
of life (QUAL-E); 19: Quality of Dying and Death Questionnaire (QODD); 20: Quality of Life Questionnaire (QLQ).
FOR MORE INFORMATION!
Contact iltcresearch@aic.sg or 6603 6991/6632 1110.
Findings
17
R&E
COLUMN
29 systematic reviews were included in this
review and 20 tools of adequate
psychometric quality were identified. The
identified HR-QoL tools were classified
according to type of services, clients, and
assessors (see Table 1). This classification is
in line with the literature and also meets the
needs of Singapore’s ILTC sector.
Practitioners can use the table by first
identifying the target clients’ conditions and
service setting, then selecting tools based
on the type of assessor. When there are
multiple tools available for the same
situation, final selection depends on
available resources and whether the tool
measures relevant domains for the initiative.
What this means for practice
The taxonomy contributes to the QoL
literature by focusing on integrated care
settings such as residential, centre-based
and home-based care. It will enable ILTC
providers to select suitable tools to assess
their clients’ HR-QoL at one point in time or
continuously, so as to support their service
planning, delivery and enhancement.
A limitation of this study is that only
English-based literature was searched.
Another limitation is that the recommended
HR-QoL tools may need to be validated
before being widely applied in Singapore.
The validation of tools in specific settings
can be achieved with further research.
Author Information
Dr Xu Lingling, Caroline Pang and
Dr Xie Shuyan Rainny work in AIC’s
Knowledge Management Division. They
currently support research and evaluation
activities related to care integration within
AIC and the ILTC sector.
More photos at:
aic.sg/mosaic/gallery/may15
REGULAR READS*
18
May 2015
COMPASSION IN PRACTICE:
TWO YEARS ON –
EXPERIENCES MATTER
by National Health Service (NHS) England (2014, November)
(Accessed: 1 April 2015)
Read the full article at: www.england.nhs.uk/nursingvision
Compassion in Practice was launched by the National Health Service (NHS) England two
years ago. It sets out a strategy for nurses and care staff to deliver tangible improvements
to support high quality care. This report reflects improvements made through six action
areas. These areas are closely linked to NHS’s 6Cs – Care, Compassion, Competence,
Communication, Courage and Commitment.
Action Area 1:
Helping people stay independent,
maximising wellbeing and improving
health outcomes
(Looks at how every person providing care
and support can help clients better
manage their health and wellbeing
effectively. Individual needs are identified
and appropriate support is put in place,
including self-management of long-term
health conditions when clients are
able/want to do so.)
• A national model, Framework for
Personalised Care and Population
Health, which focuses on prevention and
health promotion, was launched. It
provides nurses and allied health
professionals access to evidence-based
research, guidance, standards, good
practice interventions and outcome
measures. The framework contains
examples and ready-to-access
information in high priority areas such as
antimicrobial resistance, falls and
dementia, amongst others.
• Every contact between a health/social
care professional and a member of the
public is seen as an opportunity to
provide basic health promotion advice
and links to support services, if required.
In future, the NHS will work across
sectors to help integrate health, care and
support services, and leverage technology
to support practices.
Action Area 2:
Working with people to provide positive
care experiences
(Helps services get views from vulnerable
users and use their responses to make
improvements and enhance clients’ care
experiences.)
• The Friends and Family Test was rolled
out. This test looks at reported/unreported
patient/carer experiences which enable
nurses to listen/act on these views. The
test asks clients whether they would
recommend the hospital wards and/or
accident and emergency units to a
friend/relative based on their experiences.
• A programme to develop a small core set
of ‘Always Events’ was started. The
purpose of ‘Always Events’ is to support
consistency in personal interactions
between staff, patients and carers.
Nurses’ feedback on what they think
should always happen in practice has also
been gathered.
Action Area 3:
Delivering high quality care and
measuring impact
(Builds on evidence that organisations with
a high reporting culture can be safer and
deliver higher quality care consistently; it
promotes the use of measurement and
openness to understand/improve care.)
Care,
Compassion,
Competence,
Communication,
Courage and
Commitment
• Implemented the Open and Honest Care:
Driving Improvement programme. It
supports trusts to become more
transparent and measurement-focused by
publishing harm and experience information
on their website. This is then used to
improve the quality of care. Metrics and
information used have been agreed upon
by stakeholders and include pressure
ulcers, healthcare-associated infections,
falls and staff experience, amongst
others.
Action Area 4:
Building and strengthening leadership
(Promotes effective frontline leadership and
supports leaders with guidance and toolkits
to measure culture in health and social care
environments. It identifies the culture,
environment and conditions required for
reflective compassionate leadership to
develop and flourish while recognising the
impact of staff experience on care.)
• A Care Cultural Barometer is being
developed and piloted to provide
organisations with a tool to measure the
culture of care in different parts of an
organisation. This will help create right
conversations between staff and
managers to improve the staff’s working
environment and make it conducive for
delivering compassionate, patient-centred
care.
aic.sg/mosaic
Action Area 5:
Ensuring the right staff, with the right
skills, in the right place
(Provides guidance to ensure right staffing
levels are in place across a range of care
settings as well as tools and evidence to
support decision-making in relation to safe
and effective staffing. It also supports the
development and implementation of
workforce planning tools.)
• Some of the tools and guidance
developed to create the right staff mix
include: Mental Health Inpatient Staffing
Framework and How to Ensure the Right
People, with the Right Skills, are in the
Right Place at the Right Time – A Guide to
Nursing, Midwifery and Care Staffing
Capacity and Capability.
Action Area 6:
Supporting positive staff experience
(Evidence has shown a strong link between
staff experience and patients’ quality
outcomes. This area supports a positive
staff experience by recognising excellence
and best practice and showcasing
examples of how trusts are engaging with
their nursing workforce. It looks at
improving the public/professional
perception of nursing and showcases best
practices in delivering compassionate care.)
• Supports nursing staff to raise
concerns/speak up and makes sure staff
understand the need under the ‘duty of
candour’ to report/deal with concerns.
Guidance called What Makes a Good
Placement has been developed based on
best practices in clinical placements,
preceptorship and supervision. It has
been found that promoting excellent
nursing practice and a positive working
culture among existing staff leads to
providing high quality and enriching
placement experience for student nurses.
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RESOURCES ANYTIME!
19
Read Me
Online Regular Reads* is a supplement of mosAIC and
provides links to free full text journal articles in the following
eight areas:
•
•
•
•
•
•
•
•
Rehabilitation
Palliative Care
Geriatric Nursing
Infection Control
Quality Improvement
Management Skills
Integrated Care
Technology
Some of the latest journal articles include:
• Strategies for reducing falls in Long-Term Care (in the Rehabilitation issue)
• Antimicrobial stewardship in Long-Term Care Facilities: What is Effective (in the
Infection Control issue)
• Providing integrated care for older people with complex needs: Lessons from seven
international case studies (in the Integrated Care issue)
Check out www.aic-learn.sg/resources/regular-reads. Should you have any
suggestion on topics you would like to read about, contact mosaic@aic.sg.
See additional photos at our
Online Gallery
Get your own
copy of mosAIC!
Subscribe now at
aic.sg/mosAIC-form
(Free for Health and
Social Care Staff).
Visit aic.sg/mosaic/gallery/may15.
*mosAIC’s Regular Reads aims to bring to community care providers’ attention knowledge that may
be relevant and useful to their operations. This section features journal articles that highlight latest
research findings as well as good, evidence-based and innovative practices. While the articles aim to
keep community care providers informed of current developments in the sector, the views and
opinions expressed or implied do not necessarily reflect those of AIC, its directors or editorial staff.
More photos at:
aic.sg/mosaic/gallery/may15
Upcoming Courses
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Services and Nursing Homes
Date: 25 May 2015 & 9 June 2015
Time: 9am-5pm (25 May 2015)
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Duration: 1.5 days
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Date: 27-28 May 2015
Time: 9am-5pm
Duration: 2 days
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Date: 9 June 2015
Time: 2pm-5.30pm
Duration: 3.5 hours
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Date: 10,17 & 24 June 2015
Time: 9.30am-5.30pm
Duration: 3 days
Ophthalmic Skills Training for ILTC
Improving Services Through Programme
Evaluation: The Outcome Management Way!
End of Life Nursing Education
Consortium (ELNEC) – Train-The-Trainer
Planning for New Facilities Development
Date: 11 June 2015
Time: 8am-5pm
Duration: 1 day
Date: 13-15 July 2015
Time: 9am-5pm (13 & 14 July 2015)
9am-1pm (15 July 2015)
Duration: 2.5 days
Visit www.aic-learn.sg/TrainingCalendar
or contact Jasmine Kam/Claire Ong
at 6603 6886/6603 6877 for more
information.
Agency for Integrated Care
5 Maxwell Road, #10-00
Tower Block, MND Complex
Singapore 069110
Date: 24-25 June 2015
Time: 9.30am-5.30pm (24 June 2015)
9.30am-12.30pm (25 June 2015)
Duration: 1.5 days
Date: 25 June 2015
Time: 9.30am-6.30pm
Duration: 1 day
Visit www.socialserviceinstitute.sg or
contact socialserviceinstitute@ncss.gov.sg
or 6589 5555 for more information on
registration and funding criteria.
Tel: 1800 650 6060
Fax: +65 6820 0728
Email: mosaic@aic.sg
Web: www.aic.sg